Social (pragmatic) communication disorder is characterized by difficulty with the use of social language and communication skills (also called pragmatic communication by professionals). A child or teen with this disorder will have difficulty in following the ordinary social rules of communication (whether they are verbal or nonverbal), following the rules for storytelling or conversations (each person takes a turn), and changing language depending upon the situation or needs of the listener.

These kinds of problems in social communication lead to the child having a difficult time communicating effectively with others, participating in a social manner with others, and can even affect academic performance.

This disorder is most commonly diagnosed by age 5, since most children should possess adequate speech and language abilities by that time.

Specific Symptoms of Social (Pragmatic) Communication Disorder

1. Persistent difficulties in the social use of verbal and nonverbal communication as manifested by all of the following:

  • Deficits in using communication for social purposes, such as greeting and sharing information, in a manner that is appropriate for the social context.
  • Impairment of the ability to change communication to match context or the needs of the listener, such as speaking differently in a classroom than on a playground, talking differently to a child than to an adult, and avoiding use of overly formal language.
  • Difficulties following rules for conversation and storytelling, such as taking turns in conversation, rephrasing when misunderstood, and knowing how to use verbal and nonverbal signals to regulate interaction.
  • Difficulty understanding what is not explicitly stated (e.g., making inferences) and nonliteral or ambiguous meaning of language (e.g., idioms, humor, metaphors, multiple meanings that depend on the context for interpretation).

2. The deficits result in functional limitations in effective communication, social participation, social relationships, academic achievement, or occupational performance, individually or in combination.

3. The onset of symptoms is in the early developmental period.

4. The symptoms are not better accounted for by another mental disorder and are not due to a general medical or neurological condition, or to low abilities in the domains of word structure and grammar, and are not better explained by autism spectrum disorder, intellectual disability, or global developmental delay.

This diagnosis is new to the DSM-5. Code: 315.39 (F80.89)